Published Till Date Research Articles

Insights into acromioclavicular joint ganglionic cyst: diagnosis and management

Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology1.It is a rare clinical entity that can affect patients’ cosmetic appearance as well as daily living activities. Limited number of case reports have been published till date in literature. This case report presents a rare example of a ganglion cyst taking origin from acromio clavicular joint in a 62-year-old female patient, outlining the clinical presentation, diagnostic approach, and successful surgical management.

Distinct NOD2 mutations reported in three families with Blau syndrome (BS) from a single center in India - Case series and review of literature

ObjectiveBlau syndrome (BS), considered a rare pediatric autoinflammatory disease, is characterised by a triad of granulomatous arthritis, dermatitis and uveitis. Here we present a tale of three families visited in our outpatient department in the last two years (2020−2022) where more than one member was affected with either skin, ophthalmological and joint involvement with either biopsy-proven granuloma or genetic mutation at NOD2 gene suggesting the diagnosis of BS. Case seriesThe first family had three affected members where the mother and her two children had skin changes, polyarthritis and a pathogenic mutation in NOD2 gene (exon 4, c.1000C > T, p.Arg334Trp) suggesting BS. The second family had two affected members where both mother and her son had uveitis, skin changes with NOD2 mutation at exon 4 with c.1147G > A (p Glu 383 Lys) variant. The son also had polyarthritis and his skin biopsy was suggestive of granulomatous inflammation. In the third family with two affected members, we found a mutation in NOD2 on exon 4 (c 1324C > T, p.Lys 442 Phe) which was described as pathogenic with only one report published till date. ConclusionThese three cases presented to us within the last two years and led to a diagnosis of BS in three other family members with discrete mutations (commonest to rarest) on the NOD2 gene in the three families.

Laparoscopic cholecystectomy under spinal anesthesia in a 5-year-old child: A case report

Symptomatic cholelithiasis in pediatric patients should be dealt with cholecystectomy. Due to its minimally invasive nature, laparoscopic approach is better than conventional open approach. Although safety of spinal anesthesia (SA) in adult laparoscopic surgeries including cholecystectomy is well established, its use in pediatric laparoscopic surgeries is extremely limited with only a few studies being published till date. Here, we report a case of laparoscopic cholecystectomy (LC) in a 5-year-old child which was successfully managed with SA. This may be the very first case report of pediatric LC under SA.

Canine retraction and anchorage loss using self-ligating and conventional brackets with sliding mechanics: A split-mouth clinical study.

Appliance biocompatibility, orthodontic treatment efficiency and patient convenience are the major issues confronting contemporary orthodontic practice. Very few studies have been published till date regarding the efficiency of self-ligating brackets as against conventional brackets. Hence, the present study was planned to compare the rate of canine retraction between self-ligating and conventional brackets and to determine the amount of anchorage loss during canine retraction. The present clinical study was designed as a prospective, observational study comprising of 25 patients requiring first premolar extraction as a part of orthodontic treatment. Self-ligating and conventional brackets were bonded using a split-mouth study design randomly. Retraction of canines was done with 150 grams of force using Dontrix gauge with E-chains. The study was conducted in relation to upper arch only, while the rate of retraction was evaluated every 4 weeks for 3 months. Average rates of retraction in 3 months were calculated. For anchorage loss, an acrylic guide plug was used in mid-treatment cast (T0) and after 3 months of retraction (T3). The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA). Independent t-test was used to compare the means of the two variables studied, while Pearson's correlation coefficient was used to evaluate the correlation between the variables studied in the groups included. P < .05 was considered statistically significant. The correlation coefficient between the average rate of canine retraction with self-ligating brackets vs. conventional brackets over a period of 3 months came out to be 0.6434, while on comparing the data in terms of anchorage loss over a period of 3 months, the respective correlation coefficient value was found to be 0.6659 with the results being statistically highly significant in either case (P < .001). Self-ligating brackets showed double the amount of displacement compared to conventional brackets in some of the cases. Also, chair side time was significantly reduced with self-ligating brackets as against conventional brackets.

EP-325 Congenital peritoneal encapsulation rare pathology for Acute intestinal Obstruction

Abstract Background Congenital peritoneal encapsulation (CPE) is a rare, congenital entity in which the small bowel is surrounded by an accessory peritoneal membrane. This condition is usually asymptomatic and rarely causes intestinal obstruction. This report highlights this rare congenital anomaly as a cause of intestinal obstruction. Case A 28-year-old fit man presented to A&amp;E with classical features of intestinal obstruction. Abdominal CT scan showed features of mechanical small bowel with 360-degree rotated mesentery, and a suspicion of closed loop obstruction. An emergency laparotomy was performed. A large congenial peritoneal sac, wrapped the small bowel from D-J flexure to proximal part of ileum, and this sac was rotated 360 degrees with multiple adhesions and a single band to the left lateral wall. Early ischemic changes were noted, along with congested mesentery. The sac was opened, dissected and adhesiolysis was performed. The thick solitary band was released. There was immediate restoration of the blood supply and the bowel was viable. Patient recovered and discharged home on day 3 Discussion and conclusion Worldwide, only 50 cases on CPE have been published till date, with the maximum reported from the UK. The other common conditions that mimic CPE are internal paradodenal hernia, abdominal cocoon and sclerosing encapsulating peritonitis. Young patients with abdominal pain and feature of closed loop high small bowel obstruction on CT scan will need a high index of suspicion, before confirming the diagnosis. At this point, it will remain a rare occurrence and an incidental finding at laparotomy.

Global Trends of Research Productivity in Natural Fibre Reinforced Composites: Comprehensive Scientometric Analysis

ABSTRACT The research on natural-fiber-reinforced composites (NFRC) has been evolving rapidly with many academic publications in recent decades for their potential applications in automotive, textiles, furniture, healthcare, biofuel sectors, and so on. Hence, an attempt is made to provide an overview of NFRC literature by employing novel scientometric and network analysis tools to examine 1143 articles extracted from Scopus database between 2010 and 2022. The novelty in the manuscript that is scientometric and network analysis of different disciplines and, tracking the latest developments would pull of great interest for plenty of much researcher and scholar because today’s some scientific output just focuses on interest, effort, and attention of policy-makers. Results obtained through this work describe the real impact of the research published till date and its usage; it also gives directions for new researchers who wish to perform research on NFRC.

Review on development of metal/ceramic interpenetrating phase composites and critical analysis of their properties

Metal/ceramic composites are in high demand in several industries because of their superior thermo-mechanical properties. Among various composite types, the interpenetrating phase composites (IPCs) with percolating metallic and ceramic phases offer manifold benefits, such as a good combination of strength, toughness, and stiffness, very good thermal properties, excellent wear resistance, as well as the flexibility of microstructure and processing route selection, etc. The fabrication of metal/ceramic IPCs typically involves two steps - i) processing of an open porous ceramic body, and ii) infiltration of metallic melt in the pores to fabricate the IPC. Although significant progress has been made in recent years for developing both porous ceramics and melt infiltration methods, to the best of the knowledge of the authors, no review article summarizing all the aspects of processing and properties of IPCs has been published till date. This review article is aimed at filling this gap. Starting with a brief introduction about the current status and applications of IPCs, the various processing routes for fabricating open porous ceramic preforms and melt infiltration techniques have been discussed. Subsequently, the data available for various important physical, mechanical, and thermal properties for IPCs have been critically analyzed to thoroughly understand their dependence on various structural and processing parameters. To compare the properties of IPCs with other relevant materials, seven different Ashby material property maps have been used, and the domains for IPCs have been created in them. For each map, the concept of material indices has been employed to critically discuss how IPCs perform in relation to other material classes for various optimum design conditions. Finally, a detailed future outlook for further research on IPCs has been provided.

Chitosan Nanoparticles: An Approbative System for the Delivery of Herbal Bioactives

: Chitosan, a natural biodegradable polymer obtained from deacetylation of chitin, has been used as an approbative macromolecule for the development of various novel drug delivery systems. It is one of the most favorable biodegradable carriers for nanoparticulate drug delivery due to its intrinsic properties, such as biocompatibility, biodegradability, non-toxicity, availability of free reactive amino groups, and ease of chemical modification into different active derivatives. Furthermore, interesting physical properties (film-forming, gelling and thickening) make it a suitable candidate for formulations, such as films, microcapsules, beads, nanoparticles, nanofibres, nanogel and so on. Researchers have reported that chitosan nanoparticles act as a promising vehicle for herbal actives as they provide a superior alternative to traditional carriers and improve pharmaceutical efficiency. As no review of chitosan nanoparticles encapsulating herbal extracts and bioactives has been published till date, a maiden effort has been made to collate and review the use of chitosan nanoparticles for the entrapment of phytoconstituents to yield stable, efficient and safe drug delivery systems. Additionally, the paper presents a comprehensive account of the state-of the-art in fabricating herbal chitosan nanoparticles and their current pharmacological status. A list of patents on chitosan nanoparticles of herbal actives has also been included. This review is intended to serve as a didactic discourse for the formulation scientists endeavoring to develop advanced delivery systems for herbal actives.

TEMPORARY IMMEDIATE FACIAL NERVE PALSY AFTER LOCAL ANESTHESIA INJECTION FOR THE REPAIR OF EAR LACERATION

Peripheral facial nerve paralysis constitutes a rare side effect of local anesthesia. The previously reported cases mainly constituted patients operated for dental and oro-maxillofacial procedures, but not commonly encountered in ear laceration repair. The literature suggests that only one or two of its branches get affected in the postoperative period, and complete involvement of facial nerve never occurred. We report a case of unilateral facial nerve paralysis immediately following the administration of local anesthesia (lidocaine 1% with adrenaline 1:100,000) in a rhomboid block prior to suturing a laceration of the left pinna, followed by full recovery within the next 4 hours without any surgical intervention. To our knowledge, no similar data has been published till date considering the minimal amount of local anesthesia used, and complete involvement of facial nerve even after injecting it away from the main nerve trunk.

Insights of abrasive water jet polishing process characteristics and its advancements

Nowadays, Abrasive water jet (AWJ) machining is used in the manufacturing Industries as cutting, turning, milling and drilling processes. The application of this technology is further extended into polishing application. However, the cutting nature of the AWJ have produced the inappropriate surface conditions. Recently, the hybrid AWJ namely, Ultrasonic Assisted Abrasive Water Jet Polishing (UAAWJP) is mainly developed for polishing the complex shapes and the internal features of both metal and non-metals. Compared with other polishing technologies, UAAWJP has several advantages such as improvement in performance efficiency, higher kinetic energy, better surface quality, high precision, ease to control and absence of thermal distortions. The hybrid process is involved with variety of factors such as ultrasonic waves (frequency and vibration), abrasive particle type &size, jet pressure, traverse rate, abrasive mass flow rate, standoff distance, nozzle geometry, jet impact angle and processing time. However, the usage of conventional AWJ and UAAWJP techniques is scarce due to the lack of understanding of process mechanism and technical publications. It is mentioned that review article on AWJ polishing operations has not been published till date. Therefore, the present work is deals with the insights of previous studies on AWJ polishing and it advancements particularly in UAAWJP, and the results are presented with in view of process mechanism, features, benefits, effects and applications, and the results are also compared with other polishing techniques. The outcome of this study can also provide the better understanding and confident to the researchers and scientists on UAAWJP for further advancements and applications on it.

English

BACKGROUND Breath holding spells (BHS) are common, non-epileptic paroxysmal events that occur in children below 6 years, whose diagnosis is made many times clinically. Exact aetiology is not known, but iron deficiency was one among many proposed aetiological factors. Very few studies were published till date to determine role and effect of iron supplementation in children with breath holding spells. Hence the present study was taken up to assess the presence of iron deficiency and the effect of iron supplementation in children with breath holding spells. METHODS This prospective interventional study was performed from May 2012 to April 2017. 125 children below six years of age brought with the complaint of breath holding spells were screened for presence of anaemia and other systemic illnesses. Ten children were excluded with other organic causes and only 85 children were found to have anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months and followed up for a total period of 6 months. Response to iron supplementation was assessed in these children by measuring total number of attacks of BHS before starting iron supplementation, after supplementation of iron for three months and also at the end of follow-up period. The results were analysed by using Microsoft Office Excel. RESULTS 76.52 % (85/115) of patients had anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months. The remaining 27 cases had normal Hb % &amp; red blood cells (RBC) indices and were not included. Response to iron therapy was assessed in anaemic children with breath holding spells and we found complete response in 78.41 %, partial response in 15.91 % and no response in 5.7 %. CONCLUSIONS This study proved the role of iron therapy in anaemic children with breath holding spells. KEYWORDS Breath Holding Spells (BHS), Iron Deficiency, Anaemia, Haemoglobin

Expression of serum proteins in noise induced hearing loss workers of mining based industry

Noise Induced Hearing Loss (NIHL) is caused by excessive noise exposure due to occupational activities thus affects communication and quality of life. Prolonged occupational and environmental exposure to loud noise damages key molecules present in the micro-machinery of the ear which are required for the mechano-electrical transduction of sound waves in cochlea. Specific proteins are known to be associated with hearing loss and related structural and functional disabilities in the human inner, outer hair cells and cochlea. Rationale of this study was to identify the cochlear proteins associated with the pathophysiology of NIHL using proteomic approaches in mining based industrial workers. Total (n = 210) samples were collected from mining based industrial workers of central India. Subjects were categorized based on audiometric analysis. Proteome changes of the host serum were investigated using one and two-dimensional electrophoresis in combination with LC-MS/MS and MALDI-TOF-MS. Up-regulated 46 cochlear proteins among confirmed NIHL cases were identified by MASCOT. Shrinkage discriminant analysis provided top 25 discriminating feature proteins namely myosin, transthyretin, SERPIN, CCDC50, enkurin, transferin etc. The identified potential proteins may be used as biomarkers for early detection and to understand the pathogenic mechanism of NIHL. Evaluation of these biomarkers in follow-up cases may further aid in improving NIHL diagnosis. SignificanceHuman proteome study in Noise Induced Hearing Loss (NIHL) cases has not been published till date. This study represents most comprehensive proteomic analysis in NIHL cases taken from Indian mine workers. The identified key twenty-five discriminating feature proteins which are upregulated when an individual develops (or is in stage of development of) NIHL, provides insights into the potential roles of these varied proteins in disease progression. The proteins thus identified by proteomic approach may be used as early diagnostic biomarker to predict the occurrence of disease at very early stage.

ANTI-ULCER AGENTS: A PHARMACOLOGICAL UPDATE OF THE PAST TEN YEARS

New anti-ulcer substances are still vitally necessary for the people of countries such as India and South Africa to avoid high cost of the most prescribed marketed anti-ulcer drugs (proton-pump inhibitors). New candidate against gastric ulcer is also necessary to avoid the potential problem (enterochromaffin-like cell hyperplasia may be induced) associated with the long-term use of synthetic proton-pump inhibitors. However, the search for the novel entity against ulceration is challenging because of the complexity of the ulcer process and its role in host defense to infections. Nature is the source of remedies for the humankind. Among the different biological activities of the natural products that have been published till date, anti-ulcer is one of the most reported effects. Some single natural products such as curcumin, 1-hydroxy-3,7,8-trimethoxyxanthone, cinnamic acid, thymol, epoxycarvone, and menthol; single synthetic products such as, 4,6-diaryl-3, 4-dihydropyrimidin-2(1H)-thiones, 1,4-dihydropyrimidine derivatives, and dihydropyrimidinone and piperidine hybrids; plant products such as Aloe vera, Mangifera indica, Zingiber officinale, Azadirachta indica, Psidium guava, Carica papaya, Panax ginseng, Terminalia chebula, Ocimum sanctum, Daucus carota, and Mimosa pudica, Alpinia galangal; nutraceuticals such as garlic, cauliflower, banana, honey, cucumber, and cod liver oil with anti-ulcer effects have been discussed in this review. A complete review of literature was conducted using different databases on ScienceDirect, Scopus, PubMed, and Google Scholar. This review is a genuine attempt to explore the past 10 years’ pharmacological update of some anti-ulcer agents.

Safety and Efficacy of Ayurvedic Interventions in the Management of Conjunctivitis

Background: Conjunctivitis is a common condition of the eye that occurs worldwide and affects all ages and social strata, affecting more than 2% of the population. Conventional treatment has many options for treating the disease. Despite adequate treatment options, patients continue to suffer troublesome symptoms. Complementary and alternative medicine (CAM) therapies may play a significant role here. Systematic reviews on this topic have been published for herbal medicines. Data are available on plenty of studies individually proving efficacy and safety of various Shodhana, Shamana, and Netra Kriyakalpa in conjunctivitis. However, systematic review of Ayurveda interventions for conjunctivitis is unavailable. This study aims at a thorough review of published clinical data of safety and efficacy of Ayurvedic interventions in the management of conjunctivitis. Materials and methods: A systematic review of randomized controlled trials (RCTs), quasi-randomized controlled trials (QRCTs), controlled clinical trials (CCTs), and multiple arms clinical trials on conjunctivitis published till date will be conducted. Studies having patients fulfilling the diagnostic criteria based on the symptomatology of Abhishyanda (HF-1) explained in classic Ayurveda texts and conjunctivitis of all ages and either sex will be included. Studies in which Ayurvedic treatments (Shamana, Shodhana, or/and Netra Kriyakalpa) with any dose, type, schedule, drug, dosage form, and advised Pathayapathya (lifestyle changes) as intervention or control will be selected. The primary outcome will be the response to treatment and onset of serious adverse events. Ethics and dissemination: Formal ethical approval will be obtained. The results will be disseminated through a peer-reviewed publication. Trial registration number: International prospective register for systematic reviews (PROSPERO) number CRD42019129436.

Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre.

We report findings from a large single centre paediatric renal biopsy cohort in South Asia. We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed. A total of 1740 paediatric kidney biopsies were performed during the study period. The mean age was 12.8 ± 4.9 years (8 months to 18 years) and the male: female ratio was 1.5:1. The most common indication for renal biopsy was nephrotic syndrome (63.2%) followed by acute nephritic syndrome (13%). Minimal change disease was the most common cause of nephrotic syndrome while endocapillary proliferative glomerulonephritis (65.7% infection related), remained the commonest cause of acute nephritic syndrome. IgA nephropathy was the commonest cause of chronic kidney disease. Contrary to trends in European paediatric cohorts, the frequency of lupus nephritis increased over the two decades of the study, while that of endocapillary proliferative glomerulonephritis did not show any appreciable decline. This study provides the largest data on biopsy proven renal disease in children from South Asia published till date and highlights important differences in the spectrum and trends of kidney disease compared to data from other regions.

CURRENT DEVELOPMENTS ON ANTI-INFLAMMATORY NATURAL MEDICINES

New anti-inflammatory substances are still vitally necessary due to intolerable side effects of the marketed anti-inflammatory drugs; however, the search for the novel entity against inflammation is challenging because of the complexity of the inflammatory process and its role in host defense to infections. Nature is the source of remedies for the mankind. Among the different biological activities of natural products that have been published till date, anti-inflammation is one of the most reported effects. In this review, we have discussed the current (2009–2018) information of some single natural products (quercetin, parthenolide, resveratrol, curcumin, cucurbitacin, capsicin, 1,8-cineole, bromelain, boswellic acid, lyprinol, and coumarin), plant products (garlic, ginger, papaya, blueberry, aloe, broccoli, olive, and rosemary), and non-plant products (marine sponges, mushrooms, and honey) having anti-inflammatory effects. Current information is mainly based on the molecular mechanisms of the above-mentioned products.

Generalized Mosaic Neurofibromatosis Type 1: A Rare Case Report

Neurofibromatosis (NF) consists of group of genetically inherited disorders all of which is characterized by occurrence of nerve sheath tumors. There are eight different subtypes of neurofibromatosis. Segmental NF, a rare mosaic pattern of NF- type1 (NF1) is diagnosed in individuals who have typical features of NF1 restricted to one part of the body and whose parents are both unaffected. But recently the nomenclature has been changed to mosaic NF. We report a case of neurofibromatosis following the lines of blaschko. To the best of our knowledge, no such case report has been published till date of generalized mosaic NF following lines of blaschko's bilaterally symmetrically. BJHS 2018;3(1)5 :390-392

Survey on segmentation and classification approaches of optic cup and optic disc for diagnosis of glaucoma

Abstract Over the past years, use of the retinal fundus images has increased for diagnosis of retinal diseases. Glaucoma is a disease which causes damage to the optic nerve of the eye resulting in deteriorated vision. Once diagnosed, the disease cannot be treated completely, but timely detection can further control the effect of glaucoma. Detection is usually performed by analyzing the optic disc followed by optic cup present on an exit of ganglion cells in the eye. Using retinal fundus images and image processing approaches, various research studies have been published till date, but the problem of accurate segmentation of disc and cup is still a major concern. This paper aims to analyze various segmentation approaches used by different researchers for optic disc followed by the optic cup and its classification for diagnosis of glaucoma. Also, the paper addresses various research gaps and challenges which need to be dealt with for improving the accuracy of segmentation and classification.

Neurological benefits of mindfulness meditation

Meditation can be defined as a form of mental training that aims to improve an individual's core psychological capacities, such as attentional and emotional self-regulation. Research on the biological concomitants of meditation practice is sparse and has mostly focused on changes that occur during meditation compared with a resting control condition in a single experimental session. Over 2000 scientific publications on the term “meditation” have been published till date, mainly in the scientific fields such of psychology and neuroscience. If supported by rigorous research studies, the practice of mindfulness meditation might be promising for the treatment of clinical disorders and might facilitate the cultivation of a healthy mind and increased well-being.

Giant Sialolith of Submandibular Duct

Sialolithiasis is one of the most common diseases of salivary glands and commonly involves submandibular gland and ducts. "Giant sialoliths" typically measure more than 15 mm in any dimension. Here, an unusual case of sialolith in submandibular duct is reported which progressed into a giant sialolith in six months' time is reported. A 42-year-old man presented with complaints of recurrent pain and swelling in the right submandibular area. A large stone was palpable intraorally within the Wharton's duct and intra-operatively, an elongated giant sialolith of 50 mm length was found which is the second largest to be published till date.